Commonwealth of MA v. Dep't of Health & Human Servs.
923 F.3d 209
1st Cir.2019Background
- Massachusetts challenged two 2017 Interim Final Rules (IFRs) and their 2018 Final Rules expanding exemptions to the ACA contraceptive-coverage mandate for employers with religious or moral objections, arguing the rules would cause state fiscal and quasi-sovereign harms.
- The IFRs allowed many more employers (including some for‑profit and nonprofit entities) to opt out of providing FDA‑approved contraceptive coverage or to use the existing "Accommodation;" the Departments published a Regulatory Impact Analysis estimating nationwide effects.
- Massachusetts cited state laws (including the 2017 ACCESS Act) and state-funded programs (MassHealth and state reproductive health programs) that would likely bear increased costs if residents lost employer-provided contraceptive coverage; state statutes do not reach ERISA‑governed self‑insured plans (approx. 56% of privately insured residents).
- The district court held Massachusetts lacked Article III standing to challenge the IFRs and did not reach the merits; Massachusetts appealed; the Departments later issued superseding Final Rules and national injunctions against those rules in other cases.
- The First Circuit held Massachusetts' procedural APA challenge to the IFRs was moot (because the Final Rules superseded the IFRs), but Massachusetts retained Article III standing to press substantive challenges to the Final Rules based on a demonstrated imminent fiscal injury traceable to the rules.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Mootness of substantive challenges | Final Rules are effectively the same as IFRs; substantive challenge remains live | Final Rules supersede IFRs but do not moot substantive claims | Substantive challenges not moot — Final Rules similar enough to IFRs to preserve controversy |
| Mootness of procedural (APA notice-and-comment) challenge to IFRs | Procedural defects persist and should be adjudicated | IFRs superseded by Final Rules, so procedural challenge to IFRs is moot | Procedural challenge to IFRs is moot because IFRs were replaced by Final Rules after notice-and-comment |
| Article III standing — imminence/certainty | Commonwealth will incur fiscal costs (state programs, MassHealth) because some MA residents will lose employer contraceptive coverage; Departments' own analysis predicts nationwide impacts and lists MA employers likely to use exemptions | Alleged injuries are speculative: no identified specific women or employers who will cause state costs; harms not certainly impending | Massachusetts has Article III standing: it showed a substantial risk of imminent fiscal injury traced to the rules and redressable by injunction |
| Causation/redressability | Increased state expenditures are fairly traceable to exemptions and an injunction would prevent them | N/A (Departments did not contest causation/redressability once imminence shown) | Causation and redressability satisfied; injunction would avert the fiscal injury |
Key Cases Cited
- Chafin v. Chafin, 568 U.S. 165 (addressing when a case becomes moot)
- Knox v. Serv. Employees Int'l Union, 567 U.S. 298 (case-or-controversy and mootness principles)
- Burwell v. Hobby Lobby Stores, Inc., 573 U.S. 682 (RFRA/contraceptive mandate and employers' religious objections)
- Zubik v. Burwell, 136 S. Ct. 1557 (per curiam) (directing compromise between contraceptive coverage and religious objectors)
- Massachusetts v. EPA, 549 U.S. 497 (state standing for prospective injuries)
- Lujan v. Defenders of Wildlife, 504 U.S. 555 (Article III standing framework)
- Clapper v. Amnesty Int'l USA, 568 U.S. 398 (imminence and "substantial risk" standard)
- Monsanto Co. v. Geertson Seed Farms, 561 U.S. 139 (standing based on a multi-step causal chain)
- N.E. Fla. Chapter of Associated Gen. Contractors v. City of Jacksonville, 508 U.S. 656 (when replacement regulation does not moot challenge)